Pre-app Cover Details
Created On
Jul, 24 2025 17:23pm
ID #8119
Pre-app Cover Details
Attached
Required Document Checklist :
-
Merchant
(Business) DBA Name :
Testing PreApp Link
Business Legal Name :
Testing Pre App Link
Contact Name :
Charlotte Groff
Contact Phone Number :
9016010032
Physical
Address :
1164 vickery lane
City :
memphis
State :
tn
Country :
Zip :
38016
Phone Number :
9016010032
Fax Number :
Email Address :
Website :
Billing Address
Address :
1164 vickery lane
City :
memphis
State :
tn
Country :
Zip :
38016
Business Type
State incorporated in :
Public
Type of Legal Entity :
LLC
Business Type :
Retail
Business Start Date :
Jan, 01 2020
EIN/Federal Tax ID Type :
Employer Identification Number
EIN/Federal Tax ID# :
*****4567
Types of Goods Sold :
miscellaneous items
Ownership Information
Owner 1
Officer/Owners Name:
John Owner
Title :
r
Social Security:
*****1234
Home Address:
1234 testing street
City :
memphis
State:
tn
Country:
USA
Zip:
38016
Drivers License:
456789
Issue Date:
Jan, 01 2022
Expiration Date:
Jan, 01 2030
State:
TN
DOB:
Sep, 01 1965
Home Phone Number:
901-601-0032
% of Business Owned :
100
Length of Ownership :
5 years
Banking Information
Billing Type :
Gross Settlement
Name of Bank :
Fake Bank
ABA Routing :
084000016
Account :
00123654
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$ 40,000
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$ 3,500
Average Ticket :
$ 25
High Ticket :
$ 200
Business Profile
Card Swiped :
99%
Card Keyed In :
1% =
100%
Card Present :
99%
Card Not Present :
1% =
100%
Moto :
0%
Internet :
0%
Ibuxx
Notes :
testing merchant - 3.5% IBUXX
Terminal Answer
Batch Out Time :
19:00
Terminal Type :
Dejavoo P1
Communication Method :
IP-internet
Do You Dial 9 For Outside Line? :
Yes
Reprogram Terminal :
No
Equipment Purchase :
No
Equipment Rental Program :
Yes
Next Day Funding :
Yes
Tip Edit :
No
EBT :
No
FNS Number :
Tax Calculation :
No
If So Tax Rate :
1.0
Refund Policy :
None
Print Refund Policy On Footer :
Software Or POS Integration Answer
POS Software Integration :
Yes
Software Name & Version :
MP/AP Name :
RP Name :
Pricing Provided :
Statement Analysis
Receipt Header Message :
Receipt Footer Message :
